Provider Demographics
NPI:1700868668
Name:WOLF, BARBARA ANN (PHD)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:ANN
Last Name:WOLF
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 S BALLENGER HWY
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3638
Mailing Address - Country:US
Mailing Address - Phone:810-342-1000
Mailing Address - Fax:810-342-1590
Practice Address - Street 1:G3230 BEECHER RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3615
Practice Address - Country:US
Practice Address - Phone:810-342-5620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2010-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301005468103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
1017807OtherMCLAREN HEALTH PLAN
1962541318OtherMCLAREN GROUP NPI #
3W831331OtherHEALTH PLUS OF MICHIGAN
056350OtherVALUE OPTIONS
1017806OtherMCLAREN HEALTH PLAN
1017807OtherMCLAREN HEALTH ADVANTAGE
01002470OtherHEALTH PLUS OF MICHIGAN
204404OtherMCLAREN HEALTH PLAN
680B512650OtherBCBSM-BCN-FEP
0P250050OtherMCARE
1017806OtherMCLAREN HEALTH ADVANTAGE
204404OtherMCLAREN HEALTH ADVANTAGE
1962541318OtherMCLAREN GROUP NPI #